Aesthetics Sans Frontières

Oh darling, I absolutely adore that new dress; and where ever did you buy those lovely lips and matching breasts?” Yes, things have certainly changed – especially on the West Coast and Down South where it has become a sign of affluence to undergo rather exaggerated cosmetic procedures. The more pronounced the mutation, the better the buzz. As a colleague of mine in Tinsel Town recently stated, “Remember when ‘porn celebrity’ was still an oxymoron… way back, before people thought of their bodies as compromised versions of ‘silicone sex dolls?’”

Fortunately, New York has remained its own aloof island trapped forever between elite European aesthetics and East Coast self-consciousness. With a sensibility at one remove from the rest of America, savvy locals embrace an understated style with a functionalist bent. Do we want to look better? Unless your only means of employment is a cardboard sign, a cup and a forlorn look, the answer is a resounding yes. Do we want others to conclude that vanity was the motivating factor? In a city that shuns ostentation and celebrates the sublime, aspiring to perfection is hardly a carte blanche for overt revamping. So although the zeitgeist insists ‘faux youth is preferable to aging,’ broadcasting rejuvenation is frowned upon by the smart set.

Few are as aware of this ‘subdued cosmopolitan ideal’ as Dr. Ramtin Kassir, the triple-board certified facial plastic and reconstructive surgeon who is also an otolaryngologist, a specialist in head and neck surgery and an expert in sleep medicine. With extensive field experience in cosmetic, endoscopic and laser surgery, Dr. Kassir is our very own Ponce de León with a space age GPS – he is a man who has not only found the much sought-for fountain of youth, but has managed to bottle it in a discrete and tasteful manner.

The Fee and Phi of Change

Although cosmetic surgeons are often compared to highly intuitive sculptors, there are few who want a cubist or a surrealist to go to work on them. Despite the fact that we’ve all seen women whose lips could have been designed by Dali while their eyes allude to Picasso’s African period, the majority of us prefer to come off as ordinary human beings albeit in our prime. It is for this reason we opt for what Dr. Kassir so eloquently refers to as Phi, the golden ratio of 1.618.

This classical premise underpinning anatomically accurate works of art by the likes of Leonardo Da Vinci is based on a relatively simple formula. Though many cosmetic surgeons are unfamiliar with the calculations involved, Kassir employs them on a regular basis and does not shy away from elucidation. As Kassir states, “If one measures you from the top of your head to the ground and divides that by the belly button to the ground you get phi; the same is true for arm to finger tip divided by elbow to finger tip; and also for head to chin divided by the top of the nose to chin. It works for the distances between teeth, it worked for the Parthenon; it is, in short, the mathematical basis of perfect proportions and beauty.”

Cold science? Firstly, science isn’t cold; it just appears that way to those who suffer post-traumatic disorders from high school exams gone awry. As we know by now, fractals have become the best way to interpret some of the most beautiful and complex structures in nature. Math may not be the reason for the state of things but it is certainly an essential tool in understanding the way they work and function. So, regardless how ambitious or expensive the procedure, it takes a Jack-of-many-surgical-traits like Kassir to pull it off. After all, for every beanstalk of a dream, there exists the giant risk that says: Fee-fi-fo-fum, if the change is strange then the Phi was flubbed.

Art Meets Science

Artist, artisan and man of science, Dr. Kassir understands the delicate balance between the right and left-brain. “My right hemisphere sculpts, feels in 3-D, intuits, is conscious of beauty and senses the art… but it always respects the left brain, the science, the medicine, the passion for precision, the mathematics behind it all.” Likewise, Kassir is well aware that different problems necessitate different approaches. “If I am working on an aging face in its 50’s, I need to see pictures of what she looked like twenty or thirty years ago. Many of us suffer from sun damage – discrete fat pockets under the face that descend and shrink… we need to peel all that back to really see the true structure. The bone volume gets smaller, things cave in, the jawbone becomes thinner and the skeleton shrinks. So we need to fill certain areas, re-drape muscles, all in an effort to combat gravity… after which, we laser the skin to peel off the worn layers and make it look fresher.”

As in art restoration, you first need to determine the original before deciding on an appropriate course of action. “Most of my patients,” admits Kassir, “are between 52 to 55 years old… usually women – some have done maintenance, some want the whole shebang; then there are the nose patients – average age 23.5; and then the injectable market – basically this means minor interventions for anyone from twenty to thirty and more volume for those over forty.”

Face to Face to Face

Meeting Dr. Kassir for the first time, one is immediately impressed by the fact that he is far less interested in his own image than he is passionate about the work he does. Softly spoken but deliberate, his empathetic eyes wash over his sentences, punctuating ideas with a sense of childlike wonder. “My family were all doctors… my dad a pediatrician. I was told I wrote my first prescription at the age of 3,” beams Kassir with enough self-irony to make me smile but never doubt his resolve. “We came here from Iran after the revolution,” he continues, “All my immediate uncles and aunts were doctors.”

Kassir moved to Dallas, Texas where he did his undergrad pre-med studies, staying on in Galveston for face and neck surgery. As he says, “The face interested me. Liposuction was very popular but I didn’t like the idea of doing something that was often such a temporary solution… Anatomically, the head and neck fascinated me even though it was much harder to pull off.”

“Facial reconstructive surgery interested me most,” explains Kassir, “when I finished my studies in Florida, I was actually supposed to go back to Texas and set up shop with my brother but I had an aunt in New York – like my brother, a dermatologist – and when she asked me to come here… well, that was 1997 and I’ve been here ever since.” Recalling that time, Kassir chuckles “1997… cosmetic surgery was just getting really hot and the FDA hadn’t yet approved Botox – at the time, most people hadn’t even heard of it.”

Mirror Mirror

Many religions subscribe to the notion that we were made in God’s image. Of course, that’s not necessarily a reason to have an omnipresent nose. But it does make a case for maintaining humanoid features. “We had a patient,” explains Dr. Kassir, “a cat lady… with 29 previous plastic surgeries – some good, some bad – things were very off. In the end The Doctors (a TV show) did a documentary on our restoration… we operated on her a couple of times and reversed the problems. Since then we have people from all over the world coming to us – basically, we correct abnormalities and re-establish a natural look.”

Having been in business for 17 years, Kassir also does the non-surgical aesthetics from botox (Dysport being the newest and most durable variation) to lasers to injectables. “People embark upon treatment with three fears,” Kassir cautions, “anaesthesia, looking like they’ve undergone surgery – or worse, looking like a freak – and the costs. When it comes to costs the issue is often one of guilt. Should I be spending this on my child, my husband, my pet… usually you can tell their whole life story from the moment they walk in. Often it’s, ‘I’m fifty-two and I’ve already taken care of everyone else and now it’s time for me.’ They want to look better and they don’t want others to notice. ”

But come they do, and in droves. John Dryden’s dictum be damned; if God didn’t want his work mended by man then we wouldn’t have hospitals or medicine either. Cases in point: a woman on Wall Street loses her husband and worries about losing her only source of revenue if she doesn’t keep up with all the young looking people on the job. Perfect candidate. A very energetic retired army general decides to open a medical practice but wherever he goes people treat him like a ghost, asking him when he’s planning to retire. In a nutshell, Dr. Kassir can make these people shine.

Reconstructive Surgery

As a medical missionary of sorts, Dr. Kassir devotes a great deal of his private time and expenses to helping the third world and those in need. “Operation Smile (the charity to help underprivileged children with cleft lips or palates) hasn’t really penetrated the Middle East,” Kassir reflects, “but because I have connections there, a few years ago I started going.” With difficulty he continues, “I mean, it’s a different kind of society for women and removing a cleft nose or palate allows them to get married more easily and lead a normal life.” Kassir makes an effort to hold back his emotions, “I mean, we had people from orphanages travel all the way from…” The doctor’s voice breaks off and then, “Let’s just say, it’s gratifying.”

After explaining that $200 in the Middle East is enough to keep someone in a hospital overnight, it becomes evident that the good doctor has been shelling out these fees from his own pocket. “I go abroad maybe twice a year. And what I want is to train people there, to have a presence, to make a difference. I want to create a foundation – to make something that lasts, to make something that effects change.” •

Kassir rises from his seat, leaving me with the words, “we are at the forefront of a new era – one wherein we’ll be able to harvest stem cells to regenerate organs. The institutions and universities are all there. Remarkable stuff, really. It’s just a matter of time.” And so the man for whom work is often based on curbing the effects of time departs on the optimistic note that while time may not heal all wounds, it does offer us the opportunity to learn how to heal them ourselves.

Sounds like an amazing man – exceptionally insightful article. Enjoyed reading it and look forward to more like this. My friend sent this to me weeks ago but I overlooked it and only now noticed that this wasn’t just some fluff publication. Good stuff.

It’s interesting that the best people in any field are those that also do a lot of altruistic work as well. It’s not surprising that he’s be good if he did so much for those in third world countries where situations can cause incredible disfigurement.